Destigmatizing Maternal Mental Health Through Technology

Seven Starling is a digital clinic created to support women throughout their motherhood journey, helping treat mental health challenges patients may experience. In this episode, company CEO Tina Beilinson and Chief Medical Officer and practicing OB-GYN Dr. Amy Roskin explain how their startup is tackling the untreated mental health conditions and concerns women face.

Make sure you like and subscribe to "For Startups, By Physicians" wherever you get your podcasts. And keep up with us on LinkedIn, Twitter, and Medium at @InflectHealth, and on the web at InflectHealth.com.

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[00:00:00] Lindsay Kriger: Hey everyone. This is Lindsay Kriger, director at Inflect Health, the innovation hub of Vituity, where we strive to be a catalyst for better care. I'm thrilled to be hosting "For Startups, By Physicians" where we share insights and guidance to healthcare startups and technologists looking to create the future of health.

[00:00:18] Lindsay Kriger: As a physician-founded firm, we have connections with clinicians and intimate knowledge of what they need and how they work. We will be interviewing our executives, frontline providers, and industry leaders to help your business be effective and scale. 

[00:00:32] Lindsay Kriger: Thanks for joining, and let's get going.

[00:00:41] Lindsay Kriger: Tina Beilinson is the CEO and founder of Seven Starling, a digital platform focused on specialized therapy for maternal mental health. The company uses licensed therapists, peer support and medication as needed to help women navigate every stage of parenthood [00:01:00] with compassionate evidence-based mental healthcare.

[00:01:03] Lindsay Kriger: Tina's experience in leading growth initiatives helped her champion women's health. She was previously Warby Parker's Senior Manager of Strategy and Corporate Development, leading the launch of the company's optometric telemedicine service. She is a graduate of Harvard Business School. 

[00:01:21] Lindsay Kriger: Dr. Amy Roskin is Seven Starling's Chief Medical Officer with over 20 years of experience as a practicing board-certified OB-GYN. She's also an attorney who prioritizes patient safety, advocacy, and quality of care. She attended NYU for her medical degree, and Nova Southeastern University, Shepard Broad College of Law. 

[00:01:44] Lindsay Kriger: Welcome, Tina and Dr. Amy Roskin to the podcast. I'm so excited to have you on today. Thanks for being here. 

[00:01:52] Tina Beilinson: Thank you so much for having us.

[00:01:54] Dr. Amy Roskin: Thanks, Lindsay. 

[00:01:55] Lindsay Kriger: Tina, let's dive right in. Maybe tell us a little bit about Seven [00:02:00] Starling, how you formed the company, and with women's health being such a hot topic and having a really broad market, how you all decided to focus on maternal health and specifically maternal mental health. 

[00:02:15] Tina Beilinson: Seven Starling is a digital clinic focused on maternal mental health. We focus on supporting women throughout their motherhood journey and specifically focusing on treating mental health challenges they might be experiencing, with an example, postpartum depression, anxiety, which are really common during the postpartum period, but we actually support women throughout the whole motherhood journey from preconception, if they're struggling to get pregnant, miscarriage and loss pregnancy, postpartum, and early parenthood.

[00:02:44] Tina Beilinson: We all know that the challenges don't stop there, and we have a unique and specialized approach that is really focused on driving the best outcomes for our patient population. So we actually combine specialized therapists who have specific expertise and a [00:03:00] passion. We're supporting our patient population.

[00:03:03] Tina Beilinson: We integrate group support into our care model. We actually have a hybrid model of care with both individualized and group appointments. And then we also can provide medical evaluations and ongoing management for people who might benefit from medication. 

[00:03:15] Tina Beilinson: But those are the three key pillars in driving those best in class outcomes, and we're really focusing on providing that much needed care that our patient population deserves especially as you think about both access and the stigma that is so entrenched in this area. 

[00:03:33] Tina Beilinson: So that's a little bit about, we do a little bit of history on Seven Starling. So my co-founders and I met while we were studying at Harvard Business School. We actually all came to business school to found a company in the women's health space. That's something that each of us knew separately we wanted to do and focus on. And actually how we all met and eventually became co-founders is this continued sort of passion for making an impact in this space. [00:04:00] And when we originally were thinking about how we were gonna make an impact, we became really excited about this idea that community and group can drive better outcomes, specifically when it comes to maternal health. 

[00:04:13] Tina Beilinson: I think it's no secret that unfortunately the U.S. has some of the worst outcomes when it comes to maternal health of any developed country and the highest cost of care. And as we dug into that more, we actually found that one of the leading drivers of these really poor outcomes is the fact that we had so many women with untreated mental health conditions and concerns.

[00:04:36] Tina Beilinson: So that is really ultimately what led us to focus on the issue. We thought it was a root cause where no single company was really focused and one that we could do a lot of good in. 

[00:04:48] Lindsay Kriger: This podcast is not about me and all of my experiences that tick every box that Seven Starling addresses, but I, of course, as a working mom [00:05:00] and actually someone who's expecting another baby, have just really have such a deep appreciation for founders that are working in this space, and especially those that are trying to use technology to augment the traditional methods of care delivery, because as we know there is so much out there, but to access and to access appropriately and to find culturally competent and just meaningful ways of connecting is such a challenge and just kudos to the three of you for trying to address something really difficult head-on. 

[00:05:34] Lindsay Kriger: So tell us a little bit about how people find out about Seven Starling or how somebody might be introduced, or the ways that you hope in the future that this becomes a household name brand, so to speak, in terms of providing this kind of support. 

[00:05:50] Tina Beilinson: When we really thought about our patient acquisition strategy, we actually approach it by looking at the patient journey for many women during this [00:06:00] time.

[00:06:00] Tina Beilinson: And really where it starts for most women is in their OB-GYN's office. So your OB-GYN is often in the person that is your sidekick throughout your whole prenatal and postpartum journey. The person that it's often the first identifying a challenge or a mental health gate, and most OBs are screening their patients at the six-week postpartum visit to see if there are any mental health challenges, that need to be addressed. Most of our patients actually get referred to us by their OB-GYN. Many of them get referred to us right after they go through that screening process. But also a lot of them are having these conversations in the room with their OB-GYN about how they're doing, how they're healing, and we're a trusted referral source for many of them.

[00:06:51] Tina Beilinson: We've actually now developed a network of hundreds of OB-GYNs that we work with. We work with over 30% of practices in [00:07:00] the DMV area, which is where we're currently supporting patients. And it's been a really great way for us to grow organically and thoughtfully and integrate ourselves into the existing healthcare ecosystem and try to create more of that collaborative care model for the patient.

[00:07:15] Lindsay Kriger: Amy, I'm always wondering about this: Is there a historic reason why the six-week postpartum metric is the first time that a patient, a new mother, is reconnected with their care provider? From a personal perspective, it seemed like an eternity, and I know you guys are all trying to shorten that gap. 

[00:07:35] Lindsay Kriger: Tell us a little bit about what Seven Starling is trying to do and also what you all feel would be best moving forward in creating those networks and relationships and not forcing people to wait so long in between and missing diagnoses.

[00:07:51] Dr. Amy Roskin: I agree with you, Lindsay and I think a lot of that six-week mark is just arbitrary, and it may have been historically based on certain aspects [00:08:00] of healing, whether post-surgery or post-birth experience. I really think it's so important to have more support and more frequent touchpoints with people who have recently given birth.

[00:08:11] Dr. Amy Roskin: For example, I would like to see clinically a two-week follow-up. There are plenty of studies and data that show that this type of outreach and support can really help screen for and detect some early changes and challenges at the point where they can be more easily diagnosed and treated. So I'm with you there. I think we can do a lot better and be a lot more supportive of this particular population. 

[00:08:36] Lindsay Kriger: Do you find that there's a lack of openness or willingness to talk about the hardships and how can we use technology and coaching and all the great things you guys are offering to try to decrease that stigma? 

[00:08:55] Dr. Amy Roskin: I do think that there is a lack of openness, especially regarding the [00:09:00] challenges that new mothers experience.

[00:09:01] Dr. Amy Roskin: I think that contributes to the huge scope of this problem. It's essential to de-stigmatize this issue, and that's what we do at Seven Starling. These issues are really common. I see it frequently in my clinical practice as an OB-GYN. I'll tell you, there's very little emphasis on mental health during my medical training, so I'm very glad to see this issue finally getting more attention.

[00:09:25] Dr. Amy Roskin: And Seven Starling creates a safe space for people through acceptance, through support, and through the specialized focus and dedication of our entire team and our providers. 

[00:09:38] Lindsay Kriger: Tina, what is something that you foresee technology being able to help with in this space and how has it been working with the clinicians alongside of a startup to bring these worlds together? 

[00:09:55] Tina Beilinson: For supporting our patient population, it's absolutely [00:10:00] critical. Once you have a newborn or in your those late phases of pregnancy, it's really hard to get into an appointment. It's really hard to find childcare. You wanna use those extra minutes to get some sleep or take a shower. So being able to conveniently take that appointment in the comfort of your own home where you could potentially continue to be there with your baby is really, really important.

[00:10:27] Tina Beilinson: So it's really about that access that's really critical for our patient population. But then on top of that, we've developed really thoughtful and specialized programs to support that entire journey. For example, when a patient is going through Seven Starling, they not only have their appointments, but in between they get access to a bunch of content, journaling prompts, meditations, exercises all around supporting them between each of those appointments, different tools that allows them to continue to really dive in and work on the areas [00:11:00] that they're discussing with their therapist.

[00:11:02] Tina Beilinson: And then most notably, from our model, it allows us to connect people with others that are going through the same thing and really support and make the group therapy aspect work. So as part of our model, as I mentioned, we connect others with small groups of five to 10 individuals who are in the same stage and experiencing the same condition, which is immensely powerful in driving better outcomes and continuing to keep people engaged in their care. And that's really hard to do unless you're doing it remotely. It allows us to really scale that model really effectively. 

[00:11:37] Lindsay Kriger: Well, and we know there have been several very successful startups that are solely dedicated to this concept of building community. And we know that is something pre-pandemic, post-pandemic, whatever you wanna say, is here to stay because of the connection that people are craving in this changing world.

[00:11:58] Tina Beilinson: We also [00:12:00] know from our data that it drives better outcomes, which has been really fascinating to see and be able to start actually developing some metrics around. So one of the things that we found is that people who participate in our hybrid group model actually stay in care two times longer. They're attending more of their appointments, they're more engaged in their care.

[00:12:23] Tina Beilinson: Not only is it providing that community aspect, but it's getting you feeling better faster, which is exactly what we wanna see. 

[00:12:31] Lindsay Kriger: That's great to hear. 

[00:12:33] Lindsay Kriger: What do you all think about how to encourage patients, consumers in their journey on trying to find the right platforms and the right providers? How do we not just adopt technology in the healthcare space, but also, Tina, to your point, use, maintain, and be patient enough to see the outcomes from it. How do we continue to do that as an industry [00:13:00] even? 

[00:13:00] Dr. Amy Roskin: Well, I think when patients are gonna evaluate a digital platform, I think it's key to look for certain aspects of the technology because that really provides better access, as Tina was discussing. I think the specialized focus is really important here. In many areas of medicine with specific health issues, you need to find a provider or medical practice that's experienced with your particular condition. That's definitely something to look for, and that's something we're so proud of at Seven Starling, is the focus and the dedication of our providers all around these particular conditions. 

[00:13:35] Dr. Amy Roskin: In addition, although technology can bring some incredible advantages, it can also fragment people's care, and so I think it's key for people to know that the provider that you're engaging with over a digital platform, that they can communicate with your local provider, or in our case, your local OB-GYN, just to avoid this type of fragmentation. [00:14:00] This type of comprehensive continuity of care is gonna really also contribute to a better outcome. As Tina mentioned, at Seven Starling, we partner with hundreds of local providers. We're really perceived as a trusted resource for women with maternal mental health challenges, so that's something we're really proud of, but I think it's something that's extra important for people to consider when they're looking for a provider for this particular issue. 

[00:14:26] Lindsay Kriger: That makes sense. It's a challenge and we want to be mindful, and I know in the work that we do at Inflect is constantly thinking about how to meet patients where they're at, and how to invest in companies and work with founders and partners and organizations that are really forward-thinking, rather than saying, well, the patient needs to come to my OB-GYN office because this is where I am.

[00:14:54] Lindsay Kriger: That's hard for physicians though, right? You've gotta admit it's hard for any professionals that have had this [00:15:00] experience of saying, "I'm the expert, come to me", and now we're saying we need to transform and meet patients where they're at and go to the patients. Especially this type of population that's experiencing so many physical, emotional, psychosocial changes.

[00:15:16] Tina Beilinson: Absolutely. 

[00:15:17] Lindsay Kriger: Is there any advice you would give women who are managing their mental health, their maternal mental health, and in anticipation of managing a life-changing event such as this. 

[00:15:33] Dr. Amy Roskin: I think there's a lot of traditional advice given, and it's good advice. There are things like getting enough rest, making time for physical activity. Those things have been studied and they have been shown to be helpful, but I think that's really hard for new moms to be able to accomplish on a regular basis just given the situation that they're in with a new baby. I think it's critical to get the support that you need. Lean on family and friends, let them help you.

[00:15:59] Dr. Amy Roskin: I [00:16:00] think it's really important to connect with people who are going through similar challenges. People feel so isolated, but there's so many others who are going through a similar experience. And at Seven Starling, we've really found that to be a great motivator for people to connect with one another and for people to get better. And it also, again, leads to the destigmatization of these conditions. I think it's really important to talk to your provider and also, again, I can't stress enough, reach out for the help that you need. 

[00:16:33] Lindsay Kriger: Amy, do you think providers in general are becoming more willing to engage in programs like Seven Starling overall, or do you think there's still a really uphill battle that technologists and startups need to overcome in order to bridge the gap between meeting patients where they're at and the traditional experience?

[00:16:55] Dr. Amy Roskin: I think yes, in that both things are true. I think there has been, [00:17:00] thankfully, a lot more attention to this issue. We are really pleased to see how many of our OB-GYN partners are very diligent about screening and diagnosing these conditions. Unfortunately, I think a lot of the current healthcare apparatus isn't really equipped to take care of people.

[00:17:18] Dr. Amy Roskin: It's just, as an OB-GYN, I didn't provide therapy services in my office, and so I think the technology that allows people to access this care is really a difference, and we see it again with our partners and with our patients that when you utilize a service like Seven Starling, the best of both worlds, you have that OB-GYN who's really making that difference, who's really screening and diagnosing these patients, but their office may not be capable of providing those services.

[00:17:49] Dr. Amy Roskin: There may be long waits, especially to find a provider who's on your insurance plan. We're really proud of all the progress we've made to participate with insurance and to be in-network. [00:18:00] And that's what I think really allows us to reach patients to provide this access and leads to the successful outcomes that we've seen.

[00:18:08] Tina Beilinson: To add to what Amy just said, working really collaboratively with the providers to help support them to be able to have those conversations with their patients in a meaningful, productive way. As Amy alluded to earlier, There's a lot on the OB-GYN's plate. There are a lot of different issues and parts of the job that are not just delivering babies.

[00:18:34] Tina Beilinson: It can be really exhausting and overwhelming to be able to cover all of those things in a very limited time in an appointment. And so one of the things that we try to do is actually create a lot of provider-focused education. We do a number of different webinars. We put together educational materials. We do different like mock sessions of how to have different types of conversations about mental health with your [00:19:00] patient.

[00:19:00] Tina Beilinson: And we try to be a real partner in that with our providers, and I think that's really meaningful versus just trying to come into a doctor's office and asking them to refer to you. 

[00:19:10] Lindsay Kriger: Tina, any advice you wanna leave our listeners with on your journey so far on the CEO/co-founder side, where you've been and where you're going, and just anything that you wanna leave our listeners with?

[00:19:28] Tina Beilinson: Yeah, the best advice I can give is not to be necessarily focused on exactly like the solution that you thought you were gonna be focused on from day one as a founder, but really focus on the problem and how you're gonna solve that problem and be open to changing course and things seeming like they're not going in a straight line and in circles and eventually ending up in a better place than you originally thought.

[00:19:57] Tina Beilinson: I think especially in the seed [00:20:00] stage, it's a rollercoaster to say the least, and you just sometimes have to just keep pushing and staying super focused on your patient, what you're learning, and building a great team around you to get to where you need to be. So my advice is just to stay focused on a problem, not the solution.

[00:20:20] Lindsay Kriger: I love it. 

[00:20:21] Lindsay Kriger: Thank you both so much for sharing more about Seven Starling, your experiences, and of course what we all hope will be normalized as the future of healthcare for maternal health. Thank you so much. 

[00:20:33] Tina Beilinson: Thanks so much, Lindsay. Thanks for having us on. 

[00:20:37] Dr. Amy Roskin: Thanks Lindsay. 

[00:20:38] Lindsay Kriger: Thanks for joining us, and again, I'm Lindsay Kriger, director at Inflect Health. Here at Inflect, the future of medicine, care and health delivery is not just right for disruption. It's increasingly personalized, accessible, and human. 

[00:20:52] Lindsay Kriger: Make sure you like and subscribe to "For Startups, By Physicians" wherever you get your podcasts. And keep up with us on [00:21:00] LinkedIn, Twitter, and Medium at @InflectHealth and on the web at InflectHealth.com.